Kidney Week

Abstract: FR-PO567

Relationships Between Satisfaction Scores and Outcomes in Dialysis Patients

Session Information

• Physical Activity, Body Composition, Metabolism: Clinical
  October 26, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Health Maintenance, Nutrition, and Metabolism

• 1302 Health Maintenance, Nutrition, and Metabolism: Clinical

Authors

• Jiao, Yue, Fresenius Medical Care North America, Waltham, Massachusetts, United States

Yue Jiao,

• Larkin, John W., Fresenius Medical Care North America, Waltham, Massachusetts, United States

John W. Larkin,

• Reviriego-Mendoza, Marta, Fresenius Medical Care North America, Waltham, Massachusetts, United States

Marta Reviriego-Mendoza,

• Barry, Amy, Fresenius Medical Care North America, Waltham, Massachusetts, United States

Amy Barry,

• Green, Judy L., Fresenius Medical Care North America, Waltham, Massachusetts, United States

Judy L. Green,

• Usvyat, Len A., Fresenius Medical Care North America, Waltham, Massachusetts, United States

Len A. Usvyat,

• Hymes, Jeffrey L., Fresenius Medical Care North America, Waltham, Massachusetts, United States

Jeffrey L. Hymes,

• McClure, Angela, Fresenius Medical Care North America, Waltham, Massachusetts, United States

Angela McClure,

• Maddux, Franklin W., Fresenius Medical Care North America, Waltham, Massachusetts, United States

Franklin W. Maddux,

Background

Patient satisfaction is an important aspect of the quality of care provided, yet the associations to outcomes are unknown. We determined correlations between Net Promoter Score (NPS) satisfaction survey scores and clinical outcomes in hemodialysis (HD) patients.

Methods

We used clinic level data from a large dialysis provider in 2015 and 2017. NPS index assesses consumer satisfaction with a company's services via their willingness to recommend it to others; scores range from -100 to 100. We calculated Pearson’s correlation coefficient (R) between annual NPS and end-of-year quality metrics that include readmission and hospital day rates per patient year, as well as the percent (%) of patients: nonadherent with HD treatments, with arteriovenous fistula (AVF), with hemoglobin (HgB) ≥10.0 to ≤11.0g/dL, with albumin (Alb) ≥4.0g/dL, and with calcium (Ca) ≤10.0mg/dL & phosphate ≥3.0 to ≤5.5mg/dL & parathyroid hormone ≥150 to ≤600pg/mL for a composite mineral bone disorder (MBD) measure. NPS was further compared to an overall composite quality score that aggregated the above metrics and others (e.g. Kt/V). We also calculated R between changes in NPS and changes in quality metrics.

Results

We analyzed data from 2,287 in-center HD clinics. Mean NPS scores were 49.0 in 2015 and 61.3 in 2017. We found higher NPS was related to: a lower % of patients nonadherent with HD treatments (R= -0.19 in 2015 & -0.18 in 2017; both p<0.001), a higher % of patients with AVF (R= 0.11 in 2015 & 0.12 in 2017; both p<0.001), a higher % of patients with HgB ≥10.0 to ≤11.0g/dL (R= 0.09 in 2015 & 0.10 in 2017; both p<0.001), a higher % of patients with MBD laboratories in goal range (R= 0.14 in 2015 & 0.16 in 2017; both p<0.001), and a higher overall composite quality score (R= 0.13 in 2015 & 0.15 in 2017; both p<0.001). NPS was not related to readmission and hospital day rates, or the % of patients with Alb ≥4.0g/dL. The 12.3-point increase in NPS from 2015 to 2017 was related to improvements in the overall composite quality score (R= 0.06; p=0.01).

Conclusion

NPS scores were related, albeit weakly, to several quality metrics including treatment nonadherence, AVF use, anemia and MBD laboratories, and overall composite quality scores. Increases in NPS over time were weakly related to better overall composite quality scores.

Funding

• Commercial Support – Fresenius Medical Care North America